The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: Wookee on December 11, 2012, 08:00:41 PM

Title: PCL- to surgery or not?
Post by: Wookee on December 11, 2012, 08:00:41 PM
Hello everyone! Like many here my first post comes after finding this site very useful for info following a knee injury. Now I need a bit more help please.... (UK Based)

6 months ago I had a motorbike collision that has resulted in "an extensive tear of the PCL with disruption of the interior fibres" a "tear to the posterior horn of the medial meniscus" and a "tear of the LCL". All this according to an MRI report that I had 4 months post injury. The delay was because the ligament damage wasn't noticed at first and I've never been in any pain from it, but I can't run or skate so my work and social life are affected.

 By complete accident I was referred to two different OS, one who I requested (Mr Thomas) as he has repaired cartilage in both knees about 15 years ago (due to a lifetime of ice hockey) and another (Mr Satish) by accident.

 My Physio, who diagnosed the injury in the first place was of the opinion that surgery would be the probable outcome. So, when I saw Mr Satish last month I wasn't surprised when he recommended surgery as the only real option for me due to the extent of the tear and the movement of my tibia. He uses an artificial implant to do the repair to the PCL.

 Today I saw Mr Thomas and now I'm confused. He had had my report in advance and after examination he confirmed what he already thought and that I didn't need surgery as there was only a 25% chance of improving on what I have now. He suggested physio and a brace and perhaps a change of job role (I'm a Police Officer so really need to be able to run).

 I can accept if I'm no longer able to play competitive sport (44 is a good age to retire gracefully), but I do need to be able to fast jog for about 5 minutes to be fit enough to work properly.

 I am definitely erring towards surgery. but would welcome some thoughts from the forum...especially regarding this 25% chance of improvement.

Thanks all

Title: Re: PCL- to surgery or not?
Post by: GIMPocalypse on December 17, 2012, 11:37:23 PM
Hi Wookee!

I don't have any advice on the surgery front but I am struggling with a PCL (grade II tear) issue as well (in addition to a few other things.)  I'm 3 months out from my injury--but no one bothered to figure out what was really wrong with me until a month ago.  I was in PT but the OS took me out and now I am just in a brace.  I am unsure if it is the lack of PT or what but I am now completely dependent upon the brace and can now only really bare weight if the brace is on--which is ridiculous because when I was in PT I had just done my first day of a month later I am looking at getting a wheelchair when I go to a theme park with friends over the holiday.

Please let us know what decision you end up making and keep us up-to-date on your progress.  There are not a lot of PCL people around here!!
Title: Re: PCL- to surgery or not?
Post by: Wookee on January 17, 2013, 04:59:23 PM
Well, the surgery option won out!

 After speaking to physios and others it seems that the second consultant probably wasn't that keen on PCL surgery and his advice wasn't appropriate for me with a Grade III injury.

 So, 5 days ago I had the operation in Swindon performed by Ortho Consultant Venkat Satish and am now recovering at home. During the surgery he carried out a LARS technique reconstruction of my left posterior cruciate ligament, had a bit of a cleanout of debris caused by some bone-shearing and tidied up my medial meniscus.

 He didn't have to do any repair work to my LCL as this was not damaged. I'm not that surprised by this news due to the mechanics of my initial injury ie very little lateral movement and the level of my mobility post injury and pre surgery. I could do everything, pain-free, but couldn't jog/run due to instability and occasionally had to go down stairs slowly for the same reason.

 The surgery went well and I was pain-free within 24hrs. I went home after a night in hospital which included my physio assessment and instructions. I can bend up to 45 degrees for the first two weeks then up to 90 for the following two then full ROM allowed (not expected straight away!) after that. I am also able to partial weight bear on the injured leg. I was able to sit comfortably in the front seat of a car for a 2hr journey home.